The value of cytology for the follow-up of prostatic cancer after hormone and irradiation therapy.

In a prospective study 162 patients with localized or metastasizing carcinoma of the prostate were followed by fine-needle biopsies for cytological control of the therapy. 74 patients were treated by external beam irradiation (6,000-7,000 cGy rotation technique), 88 patients by hormone therapy. Cytologic regression grading was correlated with the clinical course during 3-6 years. The study shows a good correlation between the cytologic regression grade 1 year after irradiation and the clinical course. A poor regression grade (still visible tumor cells) 1 year after irradiation was followed by rapid tumor progression in more than 70%. In these cases early introduction of additional therapy should be considered. After hormone therapy the correlation of the cytologic regression grade with the clinical course is lower. Marked cytologic regression was associated with rapid tumor progression in about 60%, while poor regression grading was followed in about 50% by a satisfactory course. Fine-needle aspiration biopsy and grading of cytological regression is useful for follow-up of prostatic cancer after irradiation therapy. After hormone treatment, the grade of cytological regression does not reflect the prognosis of the disease sufficiently, thus other clinical, enzymatic and scintigraphic parameters have to be examined especially in cases with primary evidence of a metastasizing cancer of the prostate.